Jillian Mackenzie Blanco, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61467195 Issued in WA

Practice address

6625 Lakeview Dr Apt 101
Kirkland, WA 98033-6940

Phone

(253) 642-6104

NPI assigned

Jul 27, 2023

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1548941172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 SW STEVENS ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981162621",
            "telephone_number": "208-880-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LAKEVIEW DR APT 101",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336940",
            "telephone_number": "253-642-6104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Boren Ave Ste 850",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043301",
            "country_code": "US",
            "telephone_number": "206-624-0688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "JILLIAN",
        "middle_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61467195",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60500024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Black, M.D.
• Olivia Christine Blackshie
• Tennille Kelsey Blair, N.D.
• Blake Davis PLLC (Kirkland and Redmond Orthodontics)
• Jennifer Blanchard
• Thomas John Blanford, CDP
• Karin Anne Blankenship, LMP
• Flora G Blattner, ARNP
• Jacey Blesoch
• Jasmine Blesoch

• Family Nurse Practitioner in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.